“I’m not dissing retail [pharmacy], but there’s a fiction that a pharmacist comes out and dialogues with you,” Snow said before an audience of health care decision makers at the Cleveland Clinic’s 9th Annual Medical Innovation Summit, held October 5, 2011. “In reality, a high school student hands you a script from the shelf,” he said.

Trumpeting Medco’s use of health IT in its pharmacy operations, Snow also claimed that when it comes to dispensing errors, automated pharmacy robots are “twenty-three times more accurate” than human pharmacists. In a blog post summarizing the remarks, a reporter for Pharmaceutical Executive called Snow’s comments “an attempt to demystify” the assertion that pharmacists in community settings can improve patient outcomes.

Responding to the magazine’s request for comment, Chrissy Kopple, vice president of media relations for the National Association of Chain Drug Stores (NACDS), called Snow’s comments “a window into the true thinking” of Express Scripts and Medco leadership. Defending the merger at a September 20 congressional hearing, Snow spoke in glowing terms about Medco’s “partnership with community pharmacy.”

However, Kopple told Pharmaceutical Executive that the recent speech suggests just the opposite.

“If there were any doubt about their intent to impose mandatory mail order on more patients, depriving patients of their choice of pharmacies, then these comments should erase such doubt at this point,” she said, adding that Snow’s “conflicting statements” cast doubt on claims that the combined companies would bring savings for patients, employers, and health plans.